Ma Sung Jun, Mix Michael, Rivers Charlotte, Hennon Mark, Gomez Jorge, Singh Anurag K
University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY 14214, USA.
Department of Radiation Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
J Radiosurg SBRT. 2017;4(4):325-330.
The case of a 56-year-old male who developed bronchopulmonary hemorrhage after a course of stereotactic body radiation therapy (SBRT) for centrally located squamous cell lung carcinoma is presented. The patient was previously treated with concurrent chemoradiation for stage IVA squamous cell carcinoma of the base of tongue. He showed no evidence of disease for 4 years until he developed a solitary metastasis of squamous cell carcinoma in the right hilum. He underwent a single fraction of 26 Gy with heterogeneity correction. He showed no evidence of disease for 13 months until he developed a sudden grade 4 bronchopulmonary hemorrhage. He underwent an urgent right pneumonectomy and later died of a post-operative complication. Pathologic analysis of the specimen revealed no evidence of tumor. Single-fraction SBRT of 26 Gy was sufficient to achieve complete response of his large central lung tumor. However, when treating patients with central lung tumors, some risk of mortality may be unavoidable with either SBRT or pneumonectomy.
本文介绍了一例56岁男性患者，该患者在接受针对中央型鳞状细胞肺癌的立体定向体部放疗（SBRT）疗程后发生支气管肺出血。该患者曾接受同步放化疗，治疗IV A期舌根鳞状细胞癌。他在4年时间里未出现疾病迹象，直到右肺门出现鳞状细胞癌的孤立转移灶。他接受了一次26 Gy的放疗，并进行了不均匀性校正。他在13个月内未出现疾病迹象，直到突然发生4级支气管肺出血。他接受了紧急右肺切除术，随后死于术后并发症。标本的病理分析未发现肿瘤迹象。26 Gy的单次分割SBRT足以使他的巨大中央型肺肿瘤获得完全缓解。然而，在治疗中央型肺肿瘤患者时，无论是SBRT还是肺切除术，都可能不可避免地存在一定的死亡风险。
